| NPI | 1932141298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA WOODRUFF Office Manager 860-647-9183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 039584) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005619) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-04-24 |